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History
- Referred to health
- Referred to rules
Companion bill
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Requires managed care programs to establish procedures to assure participant access to dental services to which entitled, other than through managed care provider
In Assembly Committee · Health · Sponsor Richard Gottfried
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
BILL NUMBER:S5894
Title of bill
An act to amend the social services law, in relation to requiring a managed care program to establish procedures through which participants will be assured access to medical assistance dental services to which they are otherwise entitled, other than through the managed care provider
Purpose or general idea of bill
This bill allows Medicaid clients who are members of a managed care program to obtain dental services outside of the medical program.
Summary of specific provisions
Amends subparagraph (iii) of paragraph a of subdivision 4 of section 364-j of the social services law to add dental services to the list of services which managed care participants may obtain outside of their medical program.
Justification
The Medicaid Managed Care Program was instituted to provide Medicaid recipients with improved health care through the Services of health maintenance organizations (HMO's). HMO's improve health care by establishing a relationship between a patient and a primary care provider and then Maintaining that relationship through all of that patients' interactions in the health care system.
Dental services have always been provided on a very different track than other health care services, and HMO's have very little experience in providing those services. In addition, primary care practitioners have little training ox experience in assessing either the existence or type of dental problems, or what the appropriate remedy would be. Consequently, it makes little sense to require them or the HMO to determine the necessity or degree of treatment needed. This legislation preserves both the right of Medicaid HMO's to offer dental services and the ability for participants to access such Services outside the network.
Prior legislative history
New Bill
Fiscal implications
None expected. Medicaid recipients are currently eligible for dental services and this legislation does not expand that eligibility.
Effective date
120 days after the date it shall have become law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.